A World Growing Old

Introduction RESPONSES TO AGEING The world has, over time, produced a vast range of responses towards old age. These often contradict one another, as well they might, given the ambiguities surrounding old age itself. Growing old may be regarded as a time of ripeness and fulfilment or a period of declining health and failing powers. The storehouse of human societies has amassed a great variety of ways and means of coming to terms with an experience which remains essentially that of other people, until, at last, it catches up with us too. There are good reasons not to anticipate the decline that comes with ageing, not least the tendency to avoid meeting trouble halfway. Received ideas about ageing are often a means of evasion and denial. ‘I’ll worry about that when the time comes.’ ‘I’m not going to live that long.’ ‘I believe in living in the present.’ Our own old age is almost inconceivable until it is upon us. That it is a time of serenity, or that it holds all the terrors associated with standing on the edge of eternity, are beliefs of convenience, a mechanism to distance our younger selves from our own fate. Throughout most of recorded time old bones were rare, and the great majority of people would have died by the time they reached what we would now consider middle age. In Britain, in 1901 8 per cent of the population were over 60. By 1941 this had risen to 14 per cent. In 1991 it was 20 per cent. Today, although the old are present in increasing numbers, they nevertheless suffer a different kind of invisibility. They have become part of the landscape, obstacles on the sidewalk, impediments to the accelerating tempo of life, delaying the swiftly moving crowds in their urgent forward movement. Although they constitute one-fifth of the population, as one elderly woman in North London said, ‘People look through you. If you are old and a woman, you are doubly invisible. We have become like ghosts before we die.’ The present moment inflects the ancient puzzle of old age and its meaning in ways that are historically unprecedented. In 1

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Britain, in 2002 it was remarked that for the first time there are more people over 60 than under 16. This ought, in a democracy, to give greater power to the elderly. Yet the testimony of the old suggests something different. Paradoxically, as they become more numerous, they observe a growing indifference towards them. It seems to them that the rich reservoir of their accumulated experience is a wasting – and often wasted – resource. They find themselves speaking an alien language to those who have little wish to understand. They no longer recognise the world they live in. ‘We have lived too long’ is a recurring theme. It is remarkable that, now that the elderly are so numerous in the world, they should lament their loss of influence and power. Although in the past there were cultures which exiled or even killed their old, for the most part, when they were comparatively few, they commanded both respect and obedience. It is, perhaps, easier to create myths of wisdom and discernment in hoary heads when these are uncommon; and the nodding of senescence might well frequently have passed for sagacity. But when life expectancy rises well into the 70s – and in Japan now, for women it is over 80 – the scarcity value of the old is undermined. The growing numbers of elderly in the world, far from representing a precious store of wisdom, are often perceived as a constraint upon the freedom and development of the young. It is not that large numbers of older people are abandoned or institutionalised. The myth of a more caring past persists, even though it has been rare for elderly parents to live with their families. In 1929–30, for instance, less than one-fifth of over-60s lived in extended families, and only 7 per cent lived in threegeneration households. It was more common for people to live closer to their elderly parents than is now the case: in the dense mesh of the streets of industrial Britain, relatives often lived a few doors, or a couple of streets, away. The distance between people, which some observe today, is only partly spatial. It also psychological, since the destinies of individuals diverge more obviously than they did when most people worked in the staple industry of a single town and expected their children to do likewise. Conflict between the generations is no new thing. All cultures tell of a new generation, eager to play its part in the life of society, excluded and often humiliated by those in positions of power and

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influence. And that means the old, seniors, chiefs and headmen. Youthful energy, repressed by elders, is a persistent theme. In many societies, the authority and prestige of elders were often unlimited. In Thailand, traditional law stated that wives and children were liable for the commission of crimes by the (senior, male) head of the family. ‘The liability was not due to the fact that they were members of a family, but because their status in the family was property owned by the head of the family. Which was not so different from the manner by which slaves were owned.’1 In some cultures a child could be given as payment to a creditor. A girl might be given to cancel a debt, and she would become the mistress of the individual to whom she was given. Feudalism in Europe was a hierarchical system which was believed to reflect on earth the hierarchy of heaven, with its archangels, angels and saints, and an omnipotent God at its apex. Social reconstructions of this belief in the arrangements of religious institutions, and the societies that evolved around them, have shown a remarkable persistence through time. Veneration of the elderly, especially of men, had an even more direct significance in tribal societies where the hierarchy of the dead and living was blurred. The ancestors were closest to God and had to be propitiated in order to earn their goodwill towards the living. Among the living, the oldest members of the tribe, being close to death, had a privileged relationship to all those who had gone before. Ancestor worship was an extension into the supernatural of existing family structures, in which the older members enjoyed a high level of authority. The family comprised both the material world and the invisible, but no less real, world of the spirits. The family and the tribe transcended mortality, and the oldest were the bridge between the living and the dead. Nor is this unintelligible to us. Even today, many people in the West think of the dead as ‘looking down’, ‘watching over’ the living, a mixture of guardian angel and moral police. The dead are granted the compensatory privilege of supervising our mortal lives. I was much struck, at the time of the death of Diana, Princess of Wales, by the number of cards and mementoes left by people outside Kensington Palace referring to her caring for people, and her ability to do so now from her place in heaven. Speaking ill of the dead remains a taboo, even if much

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weakened by a market avid for revelations and the true story of dead celebrities. The idea of the patriarch, the paterfamilias, the head of family, has been remarkably tenacious in all castes and classes. Their power was not uncontested – the resentment it created in the young may be read in the almost universal severity of the laws against parricide. The next generation must have been often tempted to put an end to the tyranny of those who lived on, denying them their inheritance, land and the power that went with it. This temptation had to be limited by the threat of the most draconian punishments. Nor was the power of the patriarch curbed by the coming of industrial society. Industrial discipline only strengthened the authority of senior males in all social classes, exemplified by the often tyrannical, though sometimes paternalistic, mill or factory owner. The industrial workers, who were at the mercy of the arbitrary power of employers, visited their own victimhood on those over whom they had control, their wives and children. STATUS OF THE ELDERLY Now, everywhere in the world, gerontocracy is dying, although faster in some cultures than others. In certain areas of the world, the weakening powers of the old have called forth a vigorous reaction and a sometimes violent reassertion of authority. This is one possible reading of the emergence of religious fundamentalism: the reclamation of traditional forms of social and spiritual control by priests, imams and all the other – usually aged – intermediaries between this world and the next. A reaffirmation of dominance expresses itself in a hardening of old faiths: fundamentalism, ostensibly ‘a return to tradition’, is a very contemporary phenomenon, a response to a modernisation which robs elders of power and undermines sources of authority. In Africa, where rural, clan-based societies bestowed social and religious knowledge on elders, and where the main productive resource – land – was controlled by them, these patterns were first disrupted by colonialism. Later, Western-style education discredited ancient patterns of lordship by shamans, traditional healers and priests, and empowered those who had acquired the

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skills and knowledge appropriate to a new, urbanising and industrial society. In Asia, joint and extended families are rapidly decaying under the same influences. The knowledge of the old is perceived increasingly as of dwindling use to, and an encroachment upon, the lives of a generation formed for a quite different way of living from anything known to their forebears. That the young should see this as liberation, and the elderly as evidence of deterioration, is scarcely surprising. But contemporary shifts in sensibility go far beyond a familiar cross-generational friction. They are symptomatic of more profound social and economic movements in the world, which have caught up whole cultures and civilisations in the compulsions of globalisation. These have their origin in convulsive changes that have occurred in the West, where accelerating technological innovation, ‘de-industrialisation’ and economic restructuring have rapidly removed the skills and competences of an older generation in favour of the flexibility and adaptability of the young. The ‘virtues’ of frugality, thrift and self-denial have been eclipsed, since these are an embarrassment to a consumer society where status reflects spending power, and extravagance is a sign of success. Youth has acquired a social supremacy it has hitherto rarely enjoyed. This has been at the expense of the old. LIFE EXPECTANCY AND GLOBALISATION The dramatic rise in life expectancy is, to a considerable extent, a result of the application of medical technologies, which have prolonged life far beyond anything foreseen by the introduction of the welfare state in the mid-twentieth century. But in the rich countries, other factors have contributed to the rising proportion of elderly people, some of which are puzzling. It was not anticipated that populations would fail to replenish themselves in the ‘developed’ world. In Britain, in 2002 the birth rate fell to 1.6, which is just below the level at which the population will maintain itself. Wolfgang Lutz of Austria’s International Institute for Applied Systems Analysis estimates that almost half the population of Western Europe and Japan will be over 60 by the end of the twenty-first century.2 This forecast may, of course, prove false, as demographic extrapolations often have

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been in the past. (There was, for instance, a scare in Britain in the 1930s about the future depopulation of the country. It was forecast then that the total population of Britain by 2000 would be a mere 35 million. This prediction was swiftly overtaken after the Second World War, when the birth rate rose again, affluence became widespread and, above all, young and healthy migrants from the Caribbean, India and Pakistan came to ease labour shortages, and in the process rejuvenated the population.) In spite of this, however, there is no doubt that a reduction in the proportion of people of working age in relation to the retired is imminent. The social, economic and moral consequences of these developments are far-reaching, although there is by no means unanimity on their meaning. Some researchers find nothing disturbing in the projections. Professor Jane Falkingham of London School of Economics states, ‘The number of pensioners tripled in the last century – from around 6 per cent in 1901 to 18 per cent in 2001 – and we coped with that without imploding.’3 She foresees a rise in the number of over-60s to 25 per cent as ‘manageable’, although the 5 million over-80s expected by 2021 will place pressure on health services and social care. Optimists argue that with a healthier older population and their desire to go on working longer, with continuing economic growth and improving productivity, there is no reason for excessive concern. Dr Gail Wilson is less sanguine.4 She argues that globalisation endangers the collective social transfers that are essential to elders in later life, pointing out that work, the family and collective institutions are all jeopardised by the neo-liberal ideology that presently dominates the global economy: work is decreasingly available to older people in the West (despite the current talk of raising the retirement age), as well as in the South, as the informal economy is replacing a ‘liberalised’ formal sector; family support is eroded by growing individualism, while resistance to public spending is part of the global ideological curb on state provision for old age. REPLACING THE GENERATIONS The United States is the only industrialised country which has a fertility rate above the replacement level of 2.1 children per

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woman. The United States has also maintained a fairly steady flow of immigrants from all over the world. About 30 million people in the US were born outside the country, while there are an estimated 6 million undocumented migrants. These factors combine to protect the US against the threat of drastic population decline or a very high proportion of elderly. In spite of this, however, it is estimated that by 2020 23 per cent of the US population will be over 60. After the trauma of September 11, it may be that migration into the country will become more tightly controlled; the effect of this on the population profile and, consequently, on the dynamism and energy of the US is not yet clear. In the US, the proportion of the population over 65 is expected to double by 2030 to 70 million, while the number of people over 80 will rise from 9.3 million in 2000 to 19.5 million in 2030. This will lead to increased health-care costs. In 1997, the US had the highest per capita health-care spending per person over 65 (US $12,100), by far greater than that of Canada (US $6,800) and the UK (US $3,600.) In the US, nursing home and home health-care spending doubled between 1990 and 2001, when it reached US $132 billion. In North America, on average individuals between the ages of 65 and 69 have a further life expectancy of about 15 years. Between 75 and 79 it reaches ten years, and even at 80 it is six or seven years. By 1996, in Canada 29 per cent of seniors lived alone, a figure that has grown steadily from 20 per cent in 1971. Between 1961 and 1991, the proportion of older women living alone more than doubled. These changes are due partly to shifting family structures and expectations, partly to the combination of widowhood and the higher average age among senior women in comparison with men, and partly to the greater independence that even a small pension, housing subsidies and community-based health-care supports make possible. Contrary to popular perception, the percentage of old people living in institutions and special-care homes has decreased from 10.2 per cent in 1971 to 7.3 per cent in 1996.5 This pattern is in keeping with the experience of much of the developed world, and is a result of the closing of many state institutions such as geriatric wards and hospitals.

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AGEISM International agencies, governments, national charities and local organisations now routinely commit themselves to policies against ageism. These remain largely declaratory, although legislation against age discrimination in employment has been effective in the US, where the over-60s make up a larger proportion of the workforce than in any other Western country. However this may be, the social power of the elderly shows little sign of being enhanced by their numbers. Youth, as an increasingly scarce commodity, is likely to go on appreciating in the demographic marketplace. If it has traditionally been the destiny of the young to rail against the authoritarianism and tyranny of age, there is little evidence that when the young are in the ascendant they are likely to be more merciful to their elders than these were to those subordinated to them in the past. Nevertheless, the capacity to prolong life yet further, into the tenth and eleventh decade, is constantly advertised by enthusiasts of technological progress. These promises of a provisional immortality are limited only by questions sometimes raised about the purpose and function of superfluous aged populations, their unproductiveness and their dead weight on the declining number of earners of the future. It seems we are likely to hear much more about the desirability – or otherwise – of shortening, rather than extending, the lifespan by a further 20 years. Certainly, Dr Lutz foresees what he calls, perhaps somewhat delicately, ‘intergenerational political conflict’. In this context, the discussions on euthanasia now taking place in Europe have an ominous undertone. THE YOUTH OF MIGRANTS In 1950, in Britain there were six workers for every pensioner. Today the ratio is four to one. By the middle of the twenty-first century, this will fall to 2.4 to one, unless there is further immigration. It is clear that the changing demography of the country has profound repercussions on every area of life. It cannot be treated reductively or in isolation from the great movements of population in the world set in train by globalisation.

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The governments of Europe are now in the unhappy position of trying to appease the far right, which has successfully linked the sense of insecurity of the people with xenophobia and racism. At the same time, they must manage a deficit of youth in their society as well as labour shortages in crucial areas of the economy, notably, medical and welfare services, teaching, information technology and the tourism industry. A spokesman for the racist British National Party suggested that the policies of the mainstream political parties amounted to a ‘genocide’ of the British people.6 He stated that the immigration policies of the government were creating a threat, whereby the number of youthful incomers of childbearing age and with a high birth rate would lead to whites being outnumbered by non-whites ‘within 60 years’. The hysteria engendered in recent years by the perception of ‘asylum seekers’, particularly those believed to be ‘bogus’, has made it harder to renew an ageing population by welcoming vigorous and healthy young people from elsewhere. The right has appropriated discussion, by the use of words like ‘swamp’ or ‘flood’ or ‘stemming the tide’, so that migrants now come to appear like an unstoppable force of nature: the language of natural catastrophe is employed to conceal the reality of a disaster of wholly human making. That this is against our own self-interest is barely acknowledged by political leaders. Their evasions have led to some puzzling and contradictory actions. They want to be seen conspicuously deporting ‘illegal’ migrants, while at the same time recruiting – sometimes in countries from which deportees have come – nurses, doctors, veterinary personnel, people qualified in information technology, as well as workers for the catering industry and seasonal agricultural workers. This may relieve some pressure on the labour market, but it is unlikely to redress demographic imbalances. The implications are grave. Without a more ample and permissive opening of borders, the countries of Europe may find themselves overwhelmingly populated by the middle-aged and elderly, without enough active young people to pay for the pensions systems and care on which they will depend. It might well be wondered why anyone would hesitate if it were a choice between an ethnically and age-diverse population and a country of frail but pure white elders with no one to look after them.

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WHO ARE THE ELDERLY? Apocalyptic predictions are very much in the millennial air – resource depletion, global warning, pollution, the ‘clash of civilisations’, terrorism. It is perhaps salutary to bear in mind once more the arguments against the scare of a ‘greying population’. Improvements in the health of the elderly have been quite easily achieved in Britain: the proportion of men and women at any particular age who require help with four basic activities in daily living halved between 1976 and 1991.7 This suggests that people will become dependent only much later in life than has until recently been the case. ‘Active ageing’ is now the slogan, maintaining health, fitness and mobility until late in life. In any case, the median age of the people of Britain will rise only from 38 to 44 in the next 40 years, which scarcely suggests cataclysmic change. (In 1901 the median age was 24, in 1931 30, and in 1981 almost 35.) Everything depends upon whether we place our faith in economic growth continuing as it has done for the past 25 years, or whether we believe that the demographic predictions will prove a more decisive determinant on future well-being. In any case, even definitions of the elderly are changing. Old age is not a chronological given, although for the purposes of the administration of social benefits it may be necessary to impose it. We are now seeing a different kind of elderly. Efforts to maintain health, both physical and mental, to attend carefully to diet and exercise, and to remain engaged participants in the life of society are changing the sensibility and psyche of the older person. Society may be slow to appreciate the transformation of attitudes and outlook of the elderly, but they have undergone a metamorphosis no less profound than that which changed young people into the previously unheard-of category of teenagers in the 1950s. The change in the elderly might not be so glamorous, but it is unlikely to be reversed. There isn’t a word for this new – and possibly, transient – class; perhaps we might call them the gilderly. THE COST OF AGEING Britain, it is often argued, is better placed than most other countries in Europe to keep down the costs of sustaining its

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future elderly, mainly because of the extreme modesty of the state old age pension. This represents a mere 16 to 18 per cent of the average national wage. If it remains at that level there is no reason why, even with a growing population of pensioners, the cost should rise much above the existing level of 5 per cent of GDP. This will present no problem. The more generous pensions provided by the state in Germany, France and the Netherlands will absorb between 14 and 18 per cent of GDP of those countries within 30 years. This is a far more onerous commitment. This is the optimistic view. But if employment falters, if the low-wage service economy permits little or no savings to millions of people, if other kinds of ill-health affect the elderly, what then? In what other form will the state subsidise extreme old age and infirmity so that this is not a time of penny-pinching misery and want, as it remains for about one-third of pensioners today? The projected rise in the number of elderly over the next two generations is unlikely to be reversed. Hoping for the best is a risky policy in any area of governance, and when it comes to taking care of the weak and most vulnerable it would be negligent to rely upon economic growth in perpetuity, upon the goodwill of future generations or even upon the capacity of private pension schemes to ensure the financial stability of the old. The precautionary principle ought to apply in this case, no less than in that of global warming or any other sign of potential breakdown in social, ecological or economic order. REPLENISHING THE POPULATION What is certain is that, within little more than a generation, the population of much of the developed world will be ageing and falling. It will also be fat (more than 20 per cent are expected to be obese). These mutations in European society are unparalleled in modern times, and it is scarcely surprising that the policies to deal with them are both improvised and inadequate. What does it mean, if rich societies fail to replenish themselves? Have they become too – what? – selfish? frightened? liberated? Does it matter? Are declining populations a blessing to the crowded lands of Japan or the Netherlands? Has childbearing become too burdensome? Should we celebrate the freedom of women from an ancient cycle of pregnancy and

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childbirth, subservience and enslavement to the will of men? What are the consequences of elective childlessness for the future structure and cohesion of society? Or have children simply become too expensive? In the United States, where most aspects of human life have been meticulously costed, the Department of Agriculture estimates that it now costs between US $121,000 and US $241,000 to bring up a child. A baby born today will be even more costly. By the age of 17, these omnivorous infants will have devoured between US $171,000 and US $340,000. It seems that the privileged people of the world are coming to regard children as something of a luxury. The comfort of the present depends not only upon growing inequality in the distribution of the wealth of the world, but is also constructed on the absence of the unborn. How future – and possibly depleted – generations will regard the legacy bequeathed by their begetters scarcely troubles a world which feels the pressing problems of today weigh upon it quite heavily enough without having to think about those of a distant tomorrow. THE WEST AND THE REST The Western model of development has now usurped all others and is presented as the sole source of hope and renewal to the whole world. What are the implications of this, when it creates a Japan or an Italy peopled by shadows, whose lives have been prolonged by technology far beyond anything that can be understood as their ‘natural term’? What will these people do, sitting in the low-watt penumbra of old-age homes, their hearing ruined by decades of hyper-decibel music, their eyesight dimmed by long years of voyeuristic television, their memories all but erased by the media-crowded images of the day before yesterday? Even in the West such an achievement chills the spirit. Can it be, should it be, exported globally? In its example to the world of abstention from increasing its population, we have a rare case of Europe and Japan practising what they preach – a birth control so effective that we can see future generations dwindling before our eyes. In the meantime, it is clear that the people of the rich countries will be able to ransack the countries of the South for urgently needed personnel to service our dereliction. Having already extracted maximum

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profit from their crop lands, forests, seas and mineral riches, and having taken advantage of the cheapness of their labour in the slums of Mexico City, Jakarta and Dhaka, we shall now pluck out the people they depend on most to help their own countries deal with the asperities of globalisation – doctors and nurses, carers for the old and infirm. Of course, people-stealing is not new. It was once known as slavery, but in the transformed circumstances of globalisation, this now appears as privilege. *

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This book reflects upon some of these unresolved questions. In the West, will an ageing population be sufficiently robust and healthy to contribute to the prosperity of the economy, or will it place intolerable strains on both services and society? In the South, can the rising numbers of elderly be absorbed by the traditional social safety nets of family, or will industrialisation rob them of that security without the compensations of adequate pensions and health care? In the great drama of globalisation, are the growing populations of elderly gainers or losers? Are we confronted by a ‘demographic time bomb’ or an unparalleled opportunity to make use of the experience and knowledge of the years?